Traditionally, there has been concern that massage might cause cancer cells to spread to other parts of the body. Many therapists and oncologists advise avoiding vigorous, deep tissue massage directly over a tumour or lymph nodes affected by cancer, as well as to areas that are bruised, sensitive or close to an intravenous catheter.They also recommend not using heat facilities and avoiding nail varnish or tanning treatments.

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However, Macmillan and Cancer Research UK say there is no evidence to support or disprove the idea that spa-ing with cancer is dangerous.

To spa or not to spa?

This dilemma has historically led spas to err on the side of caution and refuse to treat those who are not yet through a five-year remission period. But two NHS Trusts are leading the way with recommending complementary therapies to cancer patients. At The Royal Marsden NHS Foundation Trust, a specialist cancer hospital in London, complementary therapies including acupuncture, massage therapy, reflexology and yoga are available free of charge to NHS patients. Similarly, The Christie Trust in Manchester offers treatments including massage, aromatherapy, acupuncture/acupressure and reflexology to patients as part of its rehabilitation programme.

Consultant oncologist and Tpot (a specialist spa training company – more later) ambassador Dr Fiona Thistlethwaite at The Christie Trust has been on both sides of the fence following her breast cancer diagnosis three years ago. She says:

"I have often heard from my patients how receiving complementary therapies alongside chemotherapy helped them to cope with their situation. In May 2013, the unthinkable happened when I was diagnosed with breast cancer. I benefitted greatly from regular massage therapy throughout the course of my chemotherapy treatment and beyond, particularly when I was making my return to work."

She adds:

"I found massage relaxed my tense muscles and gave me some quiet time to switch off from the stressful experience I was going through. Now that I am back up and running at work, I encourage my patients to take up the offer of complementary therapies such as massage therapy. My personal experience has given me insight into the positive role they can play during a cancer patient's journey."

Available treatments

With little medical research and a lack of consensus among the medical community, whether and how you choose to spa may come down to personal choice. If you decide to go to a spa, you may want to choose one that offers specialist post-cancer treatments.

In the past few years, there has been a movement within the spa industry that is looking to educate therapists and spa managers about what is and what isn't possible. Tpot – The Power of Touch – is the brainchild of spa training specialist Michelle Hammond and Abi Wright, founder of Spa Breaks. Their mission is to educate industry professionals to ensure that no spa or salon will turn away a person with cancer by 2018.

Many spas now offer specialist retreats. St Brides Spa Hotel in Pembrokeshire sent their team on a Complementary Therapy in Cancer Care course run by Angela Green at Velindre Cancer Centre in Cardiff. Karen Clevely, spa manager at St Brides Spa Hotel, says:

"St Brides has introduced a 15-minute consultation and health questionnaire for cancer patients, the therapists then recommend the most effective and safe treatments on offer. Our Coastal Retreat oncology care package has been devised for cancer patients and we avoid the area of radiotherapy from two weeks before treatment until six weeks afterwards."

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She adds:

"Many clients have only been touched when having radiotherapy or needles put into them, so performing a relaxing hand or shoulder massage gives them the feel-good factor. A cancer patient needs nurturing more than anyone else."

Naturopath Sue Davis sent the therapy team from Lifehouse Spa Hotel in Essex to The Christie Trust in 2012 and also used the Tpot training course. Lifehouse offers recovery breaks for those enduring cancer treatment, using Spezia's Made for Life products, which have the Soil Association 100 % organic seal of approval.

"The treatments we give to cancer patients are non-invasive and gentle – concentrating on the hands and feet, and stroking and rocking the body during massage rather than anything vigorous... But if they fancy a cracking massage, we use organic products so as not to overtax a system that has already been through so much."

"We've always felt there was something missing. It wasn't nice saying no to people living with or beyond cancer. Jennifer uses very gentle ingredients which soothe fragile, itchy skin and she knows how to treat people with low immunity who are in need of very clean sterilised materials."

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Jennifer's pedigree is impressive. A micro-biologist, aromatherapist and product formulator, she devised the Defiant Beauty range of five face products and five body products at the invitation of her local cancer centre. She visited their chemotherapy ward to ask patients and nurses what was on their wish-list...

"The patients wanted natural, clean organic products they could trust. The nursing staff criteria was that products should be fragrance free. Not because of the power of essential oils but because fragrance can spark nausea during chemotherapy."

After just one treatment, 97 % of people with cancer experienced improved wellbeing, 78 % felt conditions including dry skin, aches and sore scalps had improved and 59 % felt 'as well as they could'.

Personal choice

For breast cancer survivor Paula Kerr, who runs Fitter, Stronger luxury retreats to help those hit by injury or illness back into fitness, being turned away from a treatment left her very angry.

"My oncologist said go ahead, so I arrived at the spa looking forward to a simple hot stone massage with lavender oil... But when they read my medical form, they said: 'We can't give you a massage but we can paint your nails instead!' I sat outside fuming. It's important you can still have a girlie day out and not feel alienated, because the cancer is already doing that to you."

That being said, if you are a cancer patient then the last thing you want is to feel that you are doing something unsafe rather than relaxing and nurturing. That's why some spas – Champneys Spa Hotels, Ragdale Hall and Grayshott Health Spa included – have nurses on site should you have any reaction to your treatment or any concerns.

Ultimately, your oncologist should be your first port of call if you're thinking about visiting a spa. Before deciding where to go, check whether the spa offers specialist treatments and remember to keep the pace you're comfortable with.

Karen Hockney the author of Breathing Out, which charts her journey through breast cancer.

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